Government Health Care Means Rationed Health Care

Hattip to Ed Morrissey at Hot Air for the above video which was produced by the Independence Institute.  As Barabara Wagner learned, the Oregon Health Plan would pay for her to kill herself but will not pay for Tarceva to fight her lung cancer.  But that’s just Oregon, maybe ObamaCare wouldn’t ration health care?

Dr. Zane F. Pollard, an Ophthalmologist in Atlanta, has an eye opening article here at American Thinker about the medical rationing he has experienced while treating Medicaid patients and the rationing of medical treatment during his service in the US Navy.

“I have taken care of Medicaid patients for 35 years while representing the only pediatric ophthalmology group left in Atlanta, Georgia that accepts Medicaid. For example, in the past 6 months I have cared for three young children on Medicaid who had corneal ulcers. This is a potentially blinding situation because if the cornea perforates from the infection, almost surely blindness will occur. In all three cases the antibiotic needed for the eradication of the infection was not on the approved Medicaid list.

Each time I was told to fax Medicaid for the approval forms, which I did. Within 48 hours the form came back to me which was sent in immediately via fax, and I was told that I would have my answer in 10 days. Of course by then each child would have been blind in the eye.

Each time the request came back denied. All three times I personally provided the antibiotic for  each patient which was not on the Medicaid approved  list. Get the point — rationing of care.

Over the past 35 years I have cared for over 1000 children born with congenital cataracts. In older children and in adults the vision is rehabilitated with an intraocular lens. In newborns we use contact lenses which are very expensive. It takes Medicaid over one year to approve a contact lens post  cataract surgery. By that time a successful anatomical operation is wasted as the child will be close to blind from a lack of focusing for so long a period of time.
Again, extreme rationing. Solution: I have a foundation here in Atlanta supported  100% by private funds which supplies all of these contact lenses for  my Medicaid and illegal immigrants children for free. Again, waiting for the government would be disastrous.”

Is there any reason to believe that such rationing would not continue under ObamaCare?  Indeed, with a vastly increased pool of patients receiving government medicine, how could such rationing not increase?

Of course all of this is probably academic.  With Secretary of Health and Human Services Kathleen Sebelius indicating that a public option is not essential for health care reform, and Senator Kent Conrad (D.ND) stating that pushing for a public option is “wasted effort” which would kill passage in the Senate,it looks like ObamaCare has as much chance of becoming reality as Obama has of being a real Messiah.  Of course, none of this is a surprise to me.  ObamaCare is simply a very bad idea that even the majorities the Democrats enjoy in both houses of Congress cannot salvage.

17 Responses to Government Health Care Means Rationed Health Care

  • While I admire Dr. Pollard for providing the necessary antibiotics out of pocket, this is a purely anecdotal example of the inefficiency of Medicaid. These same horror stories exist for private insurers, and many equally moving success stories for Medicaid also exist, yet somehow you conclude that a reformed health care system would result in more rationing of care. The story is touching, but it doesn’t support your conclusion in the slightest.

  • There’s a troublesome topic that hasn’t been discussed much which is that part of the bill that would give the government access to a person’s bank account. Consider this scenario: If a person, be he elderly or otherwise, goes to the ER for a life-threatening event and is subsequently denied coverage, would there exist the possibility that all assets of that person could be confiscated by the government in order to reimburse the health care providers for care rendered? There is a particularly evil man, George Soros, who contributes mightily to several humanitarian foundations that Zeke Emanuel also happens to author health care articles. A real stretch on my part perhaps, but I am reminded that Soros had no qualms with confiscating property belonging to those being led off to the death camps.

  • “The story is touching, but it doesn’t support your conclusion in the slightest.”

    Wrong on both counts. I find Dr. Pollard’s statements alarming rather than touching. His statements also indicate a clear intention to deny treatment by medicaid. If such attempts are made by a private insurer to do this, a consumer always has recourse to the courts and to not give their business to insurers with a poor track record of paying for treatment. When the government is the insurer, no such options are available for ill treated consumers.

  • Having legal recourse after an insurance company has denied coverage is virtually no recourse at all unless your emergency medical condition is courteous enough to wait up to several years while you pursue a (hopefully) favorable verdict. Private insurers are also largely immune to having their customers vote with their wallets, since most people can only feasibly afford the insurance their employer has chosen to offer. There seems to be some implication that the scenario encountered by Dr. Pollard can’t or doesn’t happen when private insurers are involved despite the fact that it can and does all the time.

  • djr,

    a reformed health care system would result in more rationing of care.

    Not a reformed health care system – a GOVERNMENT health care system.

    The difference with private insurers is that the coverage limits are written into the policy agreement, if the insurer does not abide by them, you have recourse to the government. If you’re on a government health care program, your recourse is “the hospice chute”.

  • djr,

    can you provide an example where a health insurance company has offered to kill it’s customer?

    Problems with enforcement in the current system do not get solved by throwing “the baby out with the bathwater”. The current system works for the overwhelming majority, the problems need to be fixed but that doesn’t mean it’s flawed in general.

    since most people can only feasibly afford the insurance their employer has chosen to offer.

    There’s a “change” we can all believe in right? Allow individuals to economically purchase a state approved plan for themselves? Wait…. the Republicans proposed this plan several times and the big “O” and all his cronies voted against it.

    ps. I’m unaware of any euthansia promotors at the top levels of private insurance companies…apparently you are, or you would see the difference.

  • “Having legal recourse after an insurance company has denied coverage is virtually no recourse at all unless your emergency medical condition is courteous enough to wait up to several years while you pursue a (hopefully) favorable verdict.”

    Actually verdicts in wrongful denial of coverage suits are frequently astronomical and many insurance companies will authorize treatment soon after receiving a letter from an attorney threatening such a suit. Having written several such letters that has been my experience.

    “Private insurers are also largely immune to having their customers vote with their wallets, since most people can only feasibly afford the insurance their employer has chosen to offer.”

    A consumer in moderate to good health can usually get an insurance policy for rather low rates, especially if he is willing to take on a high deductible for non-emergency care. I pay for my family’s insurance out of my own pocket and have done so for the past 23 years and have been able to get good rates with various insurers through careful shopping.

    “There seems to be some implication that the scenario encountered by Dr. Pollard can’t or doesn’t happen when private insurers are involved despite the fact that it can and does all the time.”

    No such implication was made by me. My point is that when the Government runs health care the consumer has no options to rationing and frequently shabby service.

  • Matt,

    Again, legal recourse is not particularly meaningful when (as in the ten day example given in the original article) you require treatment immediately. Granted, if your insurer is simply and blatantly in breech of the terms of your policy, you (or maybe your estate) will probably trounce them in a courtroom one day. But your insurer may also have conditions associated with your coverage that prevent you from getting the treatment you actually need within the timeframe you actually need it. Perhaps before agreeing to antibiotic treatment for your eye infection, you’re required to undergo some less expensive treatment that takes 10.1 days and fails. This is rationing of care, and it happens today in a perfectly legal manner without any help from the government.

    Regarding euthanasia, I’m not entirely sure where that is coming from or where it is going. I suppose I don’t know of any private insurance companies that offer to kill you (although there are many who would be happy to let you die), but I don’t think it has anything to do with whether or not health care is rationed to any greater or lesser extent under any of the proposed plans.

    Donald,

    I’ll defer to your expertise on the topic of wrongful denial of coverage, since it sounds like you have some experience there, but I think ‘wrongful’ is the operative word. Care doesn’t necessarily have to be wrongfully denied to be effectively rationed, it simply has to be limited to the point that it isn’t of any use to you at the time you need it. I can attest personally (anecdotally, I admit) to the hurdles and hoops private insurance will ask you to jump through before agreeing to a procedure or settling a claim. Given the right circumstances, that is every bit as much rationing as the situation described by Dr. Pollard.

    I’ve also had personal experience trying to secure affordable insurance without the help of an employer, and I’m honestly amazed to hear how successful you’ve been. The numbers I was quoted for a fairly modest plan (including eye care and dental, admittedly) were outrageously high, even in my mid-20s and with no pre-existing conditions. Maybe with enough time and agreeing to a high enough deductible, I could have found something acceptable, but there is just no comparison to the plan and pricing I’m able to get through my employer. I would have to be extremely angry and willing to sacrifice a huge amount of money to stick it to my current provider, and in the end, I don’t think they would miss me enough to really reflect on why they lost me as a customer. I think my situation is fairly common, and it effectively prevents me from taking my business elsewhere to any great effect.

    It may be true that government-run health care will lead to greater rationing and shabbier service, but I don’t think the article supports that argument at all. It just tells a story where adequate care wasn’t provided, and Medicaid happened to be the insurer involved. You could find a story just like this in any hospital in America where the insurer is a private company.

  • The prime problem drj with giving government a monopoly over health care, which is what the proposed House legislation would do, is just that. In a monopoly situation there is no incentive for the holder of the monopoly to provide good service. Dr. Pollard’s experience attests to what happens now in regard to Medicaid, a service provided to the poor who have no other alternative due to lack of funds. ObamaCare would put us all in that leaky boat.

  • I don’t disagree that a monopoly is terrible for consumers, and I would hate to see a government monopoly over health care. I’m not thoroughly convinced that any mechanism by which the government provides insurance necessarily leads to a government monopoly, either. But in either case, Dr. Pollard really only successfully makes the case that people without any options have no options, something that is true whether your health care comes from the government or from a private insurer. The rationing argument he makes doesn’t hold because it is in no way unique to Medicaid. Private insurance rations very clearly already and often in the exact same way, so it isn’t fair to assert that Medicaid is a leaky boat (in regard to rationing of care) and that private insurance is something different.

  • When private insurers are driven out of business drj, and that would clearly be the ultimate result of the House bill, only the government would be left as a monopoly. A multiplicity of private insurers today prevents such a monopoly. A single payer system is merely another way of saying government monopoly.

  • My folks have private insurance, have my entire life– it’s expensive, but ranches don’t offer insurance.

    Mom’s had breast cancer, two orthoscope knee operations, a knee replacement, some sort of operation on the joints of her thumb…. all with the pre-existing wear and tear of a high school track star.

    Dad has a lot of skin problems, an incorrectly healed wrist since he was in high school and a pretty solid history of stuff-spiked-through-his-foot.

    Both in their fifties, both with family histories of rather expensive medical problems.

    Private insurance hasn’t been *perfect,* but it’s been pretty dang good.

    It’s also telling that mom is the only one that we know in the valley who has had any of those surgeries and paid for them herself, and that dad’s medical massage therapist had to raise her rates (she previously had a “monthly member” style discount club for valley residents with medical problems) or she would have to stop seeing Medicaid/Medicare customers.

    From where I stand, it sure looks like the idiots who are proud and honorable enough to pay for their own dang insurance need some protection from the folks that won’t, and they sure don’t need something that a politician is promising will be as good as the Post Office!

  • djr,

    First of all, you haven’t responded to the objections about the character of government which clearly is an important element of this.

    I’m not thoroughly convinced that any mechanism by which the government provides insurance necessarily leads to a government monopoly

    we don’t need to convince you that it will absolutely happen. You support a massive expansion of government power, it is your side that must prove that it will absolutely not happen in order to justify it.

    people without any options have no options, something that is true whether your health care comes from the government or from a private insurer. The rationing argument he makes doesn’t hold because it is in no way unique to Medicaid. Private insurance rations very clearly already and often in the exact same way, so it isn’t fair to assert that Medicaid is a leaky boat (in regard to rationing of care) and that private insurance is something different.

    The problem you’re having is the “insufficient options” fallacy. The only options are not to leave the health insurance system as it is, or a “government option”. The fact is that numerous improvements to the current system do not involve the great risk that we’re concerned about but the democrats oppose them… tort reform, separating insurance from the employer, cross-state line competition… these things would solve the problem of rationing by giving people options. Appropriate oversight to ensure people get the procedures they need is important, and if it’s not happening then EACH STATE should work to resolve this as quickly as possible, there’s no need for federal infringement on this state level authority.

  • Matt,

    I guess I don’t fully understand what you mean by the ‘character of government’. Is this on the topic of euthanasia? If so, I honestly don’t give much credence to the argument that the government wants to euthanize old people, and I’m amazed and disappointed that the idea has gotten any traction. Compared to the ethics and character of private enterprise, which I think we can all admit is only interested in your health care to the extent that they can wrangle a profit from you as you try to afford it, I think it’s a wash at best.

    I don’t feel like I need to defend a massive government expansion because I’m not a proponent of government-run health care – that’s just something you’ve assumed because you see the entire issue as Us vs. Them and because my initial post was about how the content of this article doesn’t support its headline in any reasonable way. Still, it does seem clear to me that the government could be involved in health care to many different degrees, most of which don’t require the takeover that you assume would result. This should be evident by the fact that the government already is involved heavily with health care and has not thus far managed to take over the entire system.

    As for the insufficient options fallacy, you’re again assuming that I’m only interested in a government-provided solution. The argument I’m making is not for a government option, it’s against drawing bad conclusions from anecdotal accounts in an effort to convince people of something you hope they’ll believe without being offered any real evidence.

    As far as the other options you mentioned are concerned, I don’t disagree with any of them. I’m not a democrat or a republican, so I don’t find myself at odds with any political ideology for thinking that they’re good ideas. But they’re not incompatible with government intervention either, so I don’t consider it an either/or proposition. One thing the government can bring to the table that private industry can’t is a service driven by and focused on something other than quarterly profits, and I recognize that there might be a place for that somewhere in the health care industry.

    I don’t want to wander too far from the point, though. I haven’t seen any credible evidence that government care means rationing above and beyond the level we see today (especially if you treat being unable to afford or obtain insurance at all as rationing, which I think you can legitimately do), and you can’t simply tell a bad story about Medicaid, conclude that Medicaid is bad, and call that a meaningful argument.

  • Is this on the topic of euthanasia? If so, I honestly don’t give much credence to the argument that the government wants to euthanize old people, and I’m amazed and disappointed that the idea has gotten any traction.

    Well, when we have multiple examples of Gov’t healthcare doing exactly that, in this country…. What else are we supposed to think? “It can’t happen to me”?

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